I’m not a real nurse

February 12, 2015

A guest blog by Basket Press

And nor, I suspect, are many other readers of this blog. That’s according to a below the line commenter on a recent NT item on nursing pay and industrial action (I’m not giving a link as I am taking those comments as part of a broader trend, and several of us suspected some Tory party astroturfing), as “real” nurses, as opposed to the dreaded “career” nurses, would never take industrial action, especially over something as vulgar as money and anyway they only care about their patients.

“Hi, is that the electricity company? I won’t be paying my electricity bill any more, because I am a “real” nurse and don’t work for money any more, so you’ll just have to bask in my wonderfulness and commitment in lieu of money. That will be OK, won’t it?”

Rinse and repeat for every and all utility, grocery shop, etc, etc…

The obvious idiocy of suggesting that nurses (or, by extension, any other worker) should not be concerned about their financial position was not the worst of it: this person proudly proclaimed that they were not bothered about politics, implying that this was not a proper concern for a nurse, who should only think about patients…

Now, I am not sure where to start with this.

Politics. Ask yourself how the NHS came into being. Look back at Beveridge and Bevan, maybe even further to Lloyd George…The existence of the NHS and the whole welfare state depends on political decisions, it didn’t just happen by magic. It is an ideological construct, albeit one I wholeheartedly agree with (oops – spoiler alert – there may be some old-fashioned lefty views in this post, so the sensitive might like to look away now. I have a Methodist, pit village, old style Labour background, what do you expect?) and one which seeks to do the greatest good for the greatest number of people from general taxation. Compare and contrast with the health system in America, where very different political decisions about healthcare and public expenditure have been taken for very different ideological reasons.

More recently look at the increasing involvement of the private sector in the NHS: these are political decisions which shape how we can provide healthcare and also who provides care to whom, when and where.

On a more basic level, look at your patients. How and why are those particular people with those particular conditions under your care now? Can you completely rule out influences of social and economic backgrounds, educational status, employment, deprivation criteria, housing, financial factors and the rest? No, you can’t (check out the work of Peter Townsend or the Black Report) and we have known this for a long time. All those factors are influenced, if not dictated, by political decisions and have a profound effect on prevalence of many conditions and healthcare outcomes.

To claim that one is not concerned about politics is, at best, naïve, possibly a smokescreen for other ideas, definitely short-sighted and certainly irresponsible, because the politics is happening whether you like it or not and will carry on happening, no matter how much you stick your fingers in your ears and your head in the sand or wherever it is you stick your head.

But “real” nurses needn’t worry their heads about that, because they are “real” and nurses and care for their patients and that is all that is necessary.

Over to money, working conditions and what “real” nurses should think about that.

I have family connections/memories of nursing going back into the 1940s, when my mother and her cousin started nursing. These were the days of having to live in hospital accommodation, your life being run by the matron, no paid holidays, no paid sick leave, no or limited occupational pension, no 37.5 hour working week, limited days off (which could be cancelled at any moment), minimal career structure…

Ask yourself how any or all of that changed? We, through trade unions, took collective action to increase pay, improve pensions, get paid holidays, shorten the working week and the rest. Those things were not just given to us, we had to fight and negotiate to get them, up to and including strike action at times. But that can’t have been “real” nurses, being so vulgar and venal as to be concerned about something other than their patients? No, I guess it must have been the dreaded “career” nurses…Or nurses who wanted a life outside work…And a decent retirement…And have a family which needs their income…

But, hey, I’m not “real”. I’m male for a start, I’m over-educated (is it me or do those who talk about “real” not like degrees in nursing? And never seem to think that men should be involved?), I have progressed up the greasy pole, I argue (even with consultants and other nurses) and have a big hang up about the necessity for evidence, I like to do things in my time off which often require money, I like not being in debt and being able to pay my bills promptly.

There is an old nursing truism which says that if you don’t look after your staff how can you look after your patients? As far as I am concerned looking after staff includes having decent pay and conditions, as well as the other things about the immediate working environment. This involves looking more widely at the systems within which you have to work, recognising the effects of those systems, whether good or bad, and then trying to change them where necessary, which might mean industrial action if negotiation fails. It includes being aware of and seeking to influence the political decisions which WILL affect everyone of us. Not to do this is avoiding responsibility for yourself, your colleagues and, ultimately, your patients. A “real” nurse is part of society as a whole, recognises this and takes appropriate actions.